A comparative study between hyperbaric prilocaine 2% versus hyperbaric bupivacaine 0.5% for intrathecal anesthesia in cesarean section.
- 1Department of Anesthesia, Surgical ICU and Pain Management, Faculty of Medicine, Sohag University, Sohag, Egypt.
- 2Department of Anesthesia, Faculty of Medicine, Sohag University, Sohag, Egypt.
Abstract
Background
Bupivacaine has a variable block duration, while prilocaine provides a shorter, more predictable block but is less used in obstetrics. The goal is to compare the onset and duration of block induced by hyperbaric prilocaine 2% and hyperbaric bupivacaine 0.5% in intrathecal anesthesia for women undergoing elective cesarean sections (CS).Methods
A prospective randomized and double-blind clinical trial included 144 individuals with uncomplicated pregnancies belonging to the American Society of Anesthesiologists physical status I or II. Patients were divided into two equal groups randomly: prilocaine group (Group A): received 60 mg hyperbaric prilocaine 2% (3 ml) intrathecally, and bupivacaine group (Group B): received 12.5 mg hyperbaric bupivacaine 0.5% (2.5 ml) intrathecally and 0.5 ml of normal saline. As 60 mg hyperbaric prilocaine 2% is equipotent to 12.5 mg of hyperbaric bupivacaine 0.5%. Onset time and duration of sensory and motor block recorded.Results
Mean arterial blood pressure was higher in Group A than in Group B at 5, 10, 15, and 20 min (P < 0.001), with no differences at baseline or 25-45 min. Intraoperative heart rate was substantially higher in Group B at 5, 10, 15, and 20 min, with comparable values at other time points. Visual analog scale (VAS) scores were higher in Group A at 1 h (P < 0.001) but substantially lower at 2 and 3 h (P < 0.001); VAS scores at 4 h were similar between groups.Conclusion
Hyperbaric prilocaine 2% provides faster onset, shorter sensory and motor block duration, more stable hemodynamics and less maternal hypotension than hyperbaric bupivacaine 0.5% in CS, with similar neonatal outcomes and side effects.
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BibTeX
@article{hammam2026comparative,
title = {{A comparative study between hyperbaric prilocaine 2% versus hyperbaric bupivacaine 0.5% for intrathecal anesthesia in cesarean section.}},
author = {Elhadad Ali Mousa Hammam and Mostafa Mohamed Abd El Jaber Ahmed and Hala Mahmoud Hashim El Khaiat and Khaled Abdelfattah Mohamed Abdelfattah},
journal = {Saudi journal of anaesthesia},
year = {2026},
month = oct,
doi = {10.4103/sja.sja_360_26},
url = {https://europepmc.org/article/MED/42960029},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - A comparative study between hyperbaric prilocaine 2% versus hyperbaric bupivacaine 0.5% for intrathecal anesthesia in cesarean section.
AU - Elhadad Ali Mousa Hammam
AU - Mostafa Mohamed Abd El Jaber Ahmed
AU - Hala Mahmoud Hashim El Khaiat
AU - Khaled Abdelfattah Mohamed Abdelfattah
PY - 2026
DA - 2026/10/01
JO - Saudi journal of anaesthesia
DO - 10.4103/sja.sja_360_26
UR - https://europepmc.org/article/MED/42960029
AB - Background Bupivacaine has a variable block duration, while prilocaine provides a shorter, more predictable block but is less used in obstetrics. The goal is to compare the onset and duration of block induced by hyperbaric prilocaine 2% and hyperbaric bupivacaine 0.5% in intrathecal anesthesia for women undergoing elective cesarean sections (CS).Methods A prospective randomized and double-blind clinical trial included 144 individuals with uncomplicated pregnancies belonging to the American Society of Anesthesiologists physical status I or II. Patients were divided into two equal groups randomly: prilocaine group (Group A): received 60 mg hyperbaric prilocaine 2% (3 ml) intrathecally, and bupivacaine group (Group B): received 12.5 mg hyperbaric bupivacaine 0.5% (2.5 ml) intrathecally and 0.5 ml of normal saline. As 60 mg hyperbaric prilocaine 2% is equipotent to 12.5 mg of hyperbaric bupivacaine 0.5%. Onset time and duration of sensory and motor block recorded.Results Mean arterial blood pressure was higher in Group A than in Group B at 5, 10, 15, and 20 min (P < 0.001), with no differences at baseline or 25-45 min. Intraoperative heart rate was substantially higher in Group B at 5, 10, 15, and 20 min, with comparable values at other time points. Visual analog scale (VAS) scores were higher in Group A at 1 h (P < 0.001) but substantially lower at 2 and 3 h (P < 0.001); VAS scores at 4 h were similar between groups.Conclusion Hyperbaric prilocaine 2% provides faster onset, shorter sensory and motor block duration, more stable hemodynamics and less maternal hypotension than hyperbaric bupivacaine 0.5% in CS, with similar neonatal outcomes and side effects.
SN - 1658-354X
SN - 0975-3125
ER -